Memoir section 19: "The Procedure"
Nov. 30th, 2012 09:53 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
violetcheetahThe following scene includes the worst day that I have a memory of. On the upside, that means it gets cheerier from here on out.
I had heartburn. I'd been taking Pepcid for a couple of years, and it worked fine, maybe one day of heartburn a month. Then in January, it was every week; twice a week; every day; by February it was half the day. The campus doctor gave me a two-week trial of Prilosec, and it worked. At the end of the two weeks, I went back to Pepcid, and two days later the heartburn was back. He gave me another trial, but it didn't work this time.
It was such a small thing, something everyone has, all the funny commercials: Plop plop fizz fizz, r-o-l-a-i-d-s, spicy meat-a-ball. But I didn't eat spicy foods. I wasn't eating anything that wasn't white and starchy anymore — pasta with butter instead of tomato sauce, rice, potatoes. It was such a small, ridiculous thing, and I was a crybaby, a hypochondriac like my father, but it was like a tiny rock in my shoe, not even sharp, not pain exactly, just a dull poke, over and over, unrelenting.
The campus doctor referred me to a gastroenterologist. He shook his head disapprovingly at the two-week Prilosec trial. "Yeah, you aren't supposed to just stop it abruptly, it actually increases acid production when you do that." I knew it wasn't me he disapproved of, but I felt stupid anyway, like I should have somehow known better than my regular doctor. "The location of the pain is kind of low for reflux, and either way, with your family history, I think we should do an endoscopy for lesions just to be on the safe side. I'd like to do that next week." I avoided thinking too hard about the word "lesions" and made the appointment. Now there was a new discomfort in my chest, contemplating a tube down my throat, something inside me, snakelike and foreign. But people got it done all the time, and I'd be sedated. I always made too big a deal out of things.
The procedure was in the morning, of course, so I'd only gotten three hours of sleep. That was good, though, I thought: the sedative should kick right in. The nurse gave me a gown, came back in when I had changed, and handed me a paper cup with a clear liquid.
"This will numb your throat so the tube will be easier to swallow." I turned my mind away from that image; I'd be sedated, I probably wouldn't even remember it, it'd be fine. "Gargle with it three times. It'll feel weird after your done, it'll seem like you aren't breathing, but you are, you just can't feel the breath. And I'll give you the shot before that really hits, so it'll only be a few seconds, and then you'll wake up and everything will be over."
It didn't happen that way. Before the third gargle, the inside of my throat started to disappear, first just a tiny point in the center, but it spread like a paper on fire. It wasn't numb; with numb you still feel pressure. This was like the top of my skull coming off, that horrible gap of nothingness between two things that are supposed to be joined. My throat was gone, and the back of my tongue, I was drowning, my hands and arms scrabbling at the air, the armrest, beating to get the attention of the nurse whose back was to me.
"Oh!" She was surprised, seemed to hesitate in confusion, but that could be because everything had slowed down for me. Then she took the syringe from the tray and put the needle in the catheter in my arm and I locked all my concentration on the needle and the plunger and the liquid leaving the syringe and entering me. For a few seconds, my whole body disappeared along with my throat, but that wasn't so bad, because without a body, I couldn't suffocate. Then I felt my mind disappearing, and I prepared to wake up with it all over.
I half-woke to a sound, like air hissing from a tire pump. And another sound, something between a croak and a goat bleating, a slow rhythm. I felt something, below my chest, a slow throbbing. It was in time to the croaks. I was making that sound, plaintive but guttural, a sound that should never come from me. And there was something hard pressing against my insides, somewhere between my throat and chest, a stone choking me. I opened my eyes and now I could tell that I was lying on my side, and the room was dim, and blurry without my glasses, indistinct except for the human form leaning over me as I pawed with my free arm, his hand near my mouth, my mouth open wide around something, "Sorry" came from his featureless face, "Just a second, you'll be asleep again." My free arm wasn't free, someone held it to my side, someone behind me while the man's voice in front of me said "Just a second" again.
Then I was cold, and I could tell the room was lit before I opened my eyes. I was on my back, my hands at my sides under a blanket. My throat ached like I'd been talking for hours. I had a throat again. But I pushed it away from my mind, pushed my mind up and hovered over my left shoulder, not looking down at myself.
The doctor came by for a minute, "no significant findings," and then he was gone. Then Chris was there, and I was in his car, a foot from him but out of reach. I knew he had to get to work, so I don't think I asked him to stay. I wanted him to, but I didn't want him near me. I let him hug me, though, let him offer me the comfort he needed to. It wasn't one of his bear hugs, and he didn't linger. I was a bird stunned from flying into a window pane, and he was a pair of hands cradling me, moving me gently but swiftly back to my nest before I came to and panicked. I committed the moment to memory, so I could wrap it around me when it was safe to feel something.
I lay under the covers after he left, but the light was too bright to sleep. It was a drizzly day, and I'd often gone to bed at 9 a.m. on a sunny day, but it bothered me now. It was brighter when I closed my eyes, so I tried to stare at the wall until I was sleepy, but every time I started to drift, it seemed like a strobe went off and I was falling backwards, pushed backwards off a cliff like the strobe was a hand on my breastbone. But my heart twitched whenever I thought about getting up. Finally I lifted my mind up above my left shoulder again. I could see myself on the cliff, punched by the fist of brightness, but I hovered above me as I fell, and I never felt the impact.
My heart didn't stop twitching over the next week, and I didn't stop falling. Now I didn't even need to be lying in bed to slip over the lip of the cliff. I'd be on the subway and it would seem like the train lurched off the tracks, and my arm would start to go up to protect my head as the car tilted and my body went through the side window. I'd snap back to reality and look around, expecting other passengers to stare at me or to avoid staring at the crazy girl with the flailing arm. But they didn't notice, and I'd look down to see that my arm hadn't moved any more than the train had.
I would be walking on a solid sidewalk, and it would shift beneath my feet like algae'd stones on a creek crossing, loose shale on a hillside. I would feel myself stagger, feel my arms pinwheel to catch my balance, and then the sidewalk would return, and my hands would never have left in my pockets.
And there was always, always someone behind me. If I lay on my side in bed, it made sense, but when I tried lying on my back, I could feel them beneath the mattress, like the monsters of my childhood, ready to reach through the bed, reach clean through me. On the subway, with the seats sideways so the backs were against the windows, they hovered on the other side of the glass, the phanton of a hand above my shoulder, ready to yank me backward. Anywhere I walked, I fought the urge to break into a trot, and to look over my shoulder. I looked, anyway, disguising the motion as I pulled my long hair out from under my jacket collar or backpack, or stopping to kneel and tie my boot laces.
At my shrink sessions, it was impossible to keep still. It had always been like that, and I'd finally started to see the sense in it: I was focusing on uncomfortable thoughts, frightening memories, so of course I'd be on edge. I didn't notice that it had gone from a few minutes in most sessions to the whole 50 minutes, all the time. I was only aware of each moment in time as it happened, and each moment was familiar, was something that had happened before dozens of times.
About five months after the endoscopy, I sat in the chair at my shrink's office, my chest shielded by the usual off-white throw pillow in front of me, but my shoulders exposed and buzzing electrically. The torchiere in the corner was dim and blinding, and if I wasn't looking over at it, something was hiding, hunched in the shadow beneath it. But there was something hunched behind my chair, its hand wisping above my shoulder, and my head would jerk to glance at the hand, but then the corner shadow would shiver, and I'd jerk to look over there. If I concentrated, I could stare at a spot on the wall and see the corner and my shoulder out of my peripheral vision, but if my shrink distracted me with a question, one being or the other moved, and I was back to my mental game of keep-away.
My shrink said my name a couple of times, then, "Can you look at me for a minute?" I looked at his loafers and tried to ignore the other things in the room. "I think... that you might benefit from medication." The rest of the room disappeared, the other beings forgotten, and I couldn't breathe. "Violet, tell me what's going on." I realized I was standing, the pillow still in one arm, the other arm fending off phantom blows. I tried to stop moving, but my arm and hand and both shoulders spasmed uncoordinatedly. I was speaking.
"I'll be good, I'll be good, I'm sorry!" The words kept coming, a litany I was used to and hated, the way they made me feel like a small child, acting out. But I was acting out, doing it on purpose, the twitching, the glancing, I was just looking for attention, for sympathy, and I could stop on my own.
"It's not punishment, Violet." His voice had a musical tinge of laughter, not at me, but at the absurdity of my thinking. But it wasn't absurd. But it was. I was still chanting, "I'm sorry, I'm sorry."
"Just breathe. Stop talking and breathe." I took two deep breaths, but a wave of terror pulled me further away from land. Still, when the words came out now, they were different.
"But it the Prozac made me like this when I was on it, things in the corners and hands and things waiting to grab me, it was worse than now."
"No, no, I'm not thinking antidepressants, not for this." The wave receded and left me motionless, but I feared a bigger wave. He didn't continue, and it scared me. I could see his chin tilt as I stared at his shoes, and I knew he was considering his words. That scared me more, but somehow it was soothing; he was in the room with me. "This is going to sound scary, but I want you to hear all of it before you freak out. Any further." I took in a quick giggle breath. "You've heard of Risperdal."
Abnormal psych class; atypical anti-psychotics, schizophrenia, paranoia, delusions; low side effects. I nodded.
"Well, a number of psychiatrists — a small number still — have been using it to treat PTSD, the hypervigilance I think you've been feeling. It's a low dose, not what you'd use for schizophrenia. And it isn't sedating; it might make you a little drowsy the first couple of nights, but even that should be minor."
"It's not gonna... suck me down into, into nothing?"
"I don't think so." I was soothed again by the lack of absolute certainty. "If it does, you can stop."
"Okay."
I had heartburn. I'd been taking Pepcid for a couple of years, and it worked fine, maybe one day of heartburn a month. Then in January, it was every week; twice a week; every day; by February it was half the day. The campus doctor gave me a two-week trial of Prilosec, and it worked. At the end of the two weeks, I went back to Pepcid, and two days later the heartburn was back. He gave me another trial, but it didn't work this time.
It was such a small thing, something everyone has, all the funny commercials: Plop plop fizz fizz, r-o-l-a-i-d-s, spicy meat-a-ball. But I didn't eat spicy foods. I wasn't eating anything that wasn't white and starchy anymore — pasta with butter instead of tomato sauce, rice, potatoes. It was such a small, ridiculous thing, and I was a crybaby, a hypochondriac like my father, but it was like a tiny rock in my shoe, not even sharp, not pain exactly, just a dull poke, over and over, unrelenting.
The campus doctor referred me to a gastroenterologist. He shook his head disapprovingly at the two-week Prilosec trial. "Yeah, you aren't supposed to just stop it abruptly, it actually increases acid production when you do that." I knew it wasn't me he disapproved of, but I felt stupid anyway, like I should have somehow known better than my regular doctor. "The location of the pain is kind of low for reflux, and either way, with your family history, I think we should do an endoscopy for lesions just to be on the safe side. I'd like to do that next week." I avoided thinking too hard about the word "lesions" and made the appointment. Now there was a new discomfort in my chest, contemplating a tube down my throat, something inside me, snakelike and foreign. But people got it done all the time, and I'd be sedated. I always made too big a deal out of things.
The procedure was in the morning, of course, so I'd only gotten three hours of sleep. That was good, though, I thought: the sedative should kick right in. The nurse gave me a gown, came back in when I had changed, and handed me a paper cup with a clear liquid.
"This will numb your throat so the tube will be easier to swallow." I turned my mind away from that image; I'd be sedated, I probably wouldn't even remember it, it'd be fine. "Gargle with it three times. It'll feel weird after your done, it'll seem like you aren't breathing, but you are, you just can't feel the breath. And I'll give you the shot before that really hits, so it'll only be a few seconds, and then you'll wake up and everything will be over."
It didn't happen that way. Before the third gargle, the inside of my throat started to disappear, first just a tiny point in the center, but it spread like a paper on fire. It wasn't numb; with numb you still feel pressure. This was like the top of my skull coming off, that horrible gap of nothingness between two things that are supposed to be joined. My throat was gone, and the back of my tongue, I was drowning, my hands and arms scrabbling at the air, the armrest, beating to get the attention of the nurse whose back was to me.
"Oh!" She was surprised, seemed to hesitate in confusion, but that could be because everything had slowed down for me. Then she took the syringe from the tray and put the needle in the catheter in my arm and I locked all my concentration on the needle and the plunger and the liquid leaving the syringe and entering me. For a few seconds, my whole body disappeared along with my throat, but that wasn't so bad, because without a body, I couldn't suffocate. Then I felt my mind disappearing, and I prepared to wake up with it all over.
I half-woke to a sound, like air hissing from a tire pump. And another sound, something between a croak and a goat bleating, a slow rhythm. I felt something, below my chest, a slow throbbing. It was in time to the croaks. I was making that sound, plaintive but guttural, a sound that should never come from me. And there was something hard pressing against my insides, somewhere between my throat and chest, a stone choking me. I opened my eyes and now I could tell that I was lying on my side, and the room was dim, and blurry without my glasses, indistinct except for the human form leaning over me as I pawed with my free arm, his hand near my mouth, my mouth open wide around something, "Sorry" came from his featureless face, "Just a second, you'll be asleep again." My free arm wasn't free, someone held it to my side, someone behind me while the man's voice in front of me said "Just a second" again.
Then I was cold, and I could tell the room was lit before I opened my eyes. I was on my back, my hands at my sides under a blanket. My throat ached like I'd been talking for hours. I had a throat again. But I pushed it away from my mind, pushed my mind up and hovered over my left shoulder, not looking down at myself.
The doctor came by for a minute, "no significant findings," and then he was gone. Then Chris was there, and I was in his car, a foot from him but out of reach. I knew he had to get to work, so I don't think I asked him to stay. I wanted him to, but I didn't want him near me. I let him hug me, though, let him offer me the comfort he needed to. It wasn't one of his bear hugs, and he didn't linger. I was a bird stunned from flying into a window pane, and he was a pair of hands cradling me, moving me gently but swiftly back to my nest before I came to and panicked. I committed the moment to memory, so I could wrap it around me when it was safe to feel something.
I lay under the covers after he left, but the light was too bright to sleep. It was a drizzly day, and I'd often gone to bed at 9 a.m. on a sunny day, but it bothered me now. It was brighter when I closed my eyes, so I tried to stare at the wall until I was sleepy, but every time I started to drift, it seemed like a strobe went off and I was falling backwards, pushed backwards off a cliff like the strobe was a hand on my breastbone. But my heart twitched whenever I thought about getting up. Finally I lifted my mind up above my left shoulder again. I could see myself on the cliff, punched by the fist of brightness, but I hovered above me as I fell, and I never felt the impact.
My heart didn't stop twitching over the next week, and I didn't stop falling. Now I didn't even need to be lying in bed to slip over the lip of the cliff. I'd be on the subway and it would seem like the train lurched off the tracks, and my arm would start to go up to protect my head as the car tilted and my body went through the side window. I'd snap back to reality and look around, expecting other passengers to stare at me or to avoid staring at the crazy girl with the flailing arm. But they didn't notice, and I'd look down to see that my arm hadn't moved any more than the train had.
I would be walking on a solid sidewalk, and it would shift beneath my feet like algae'd stones on a creek crossing, loose shale on a hillside. I would feel myself stagger, feel my arms pinwheel to catch my balance, and then the sidewalk would return, and my hands would never have left in my pockets.
And there was always, always someone behind me. If I lay on my side in bed, it made sense, but when I tried lying on my back, I could feel them beneath the mattress, like the monsters of my childhood, ready to reach through the bed, reach clean through me. On the subway, with the seats sideways so the backs were against the windows, they hovered on the other side of the glass, the phanton of a hand above my shoulder, ready to yank me backward. Anywhere I walked, I fought the urge to break into a trot, and to look over my shoulder. I looked, anyway, disguising the motion as I pulled my long hair out from under my jacket collar or backpack, or stopping to kneel and tie my boot laces.
At my shrink sessions, it was impossible to keep still. It had always been like that, and I'd finally started to see the sense in it: I was focusing on uncomfortable thoughts, frightening memories, so of course I'd be on edge. I didn't notice that it had gone from a few minutes in most sessions to the whole 50 minutes, all the time. I was only aware of each moment in time as it happened, and each moment was familiar, was something that had happened before dozens of times.
About five months after the endoscopy, I sat in the chair at my shrink's office, my chest shielded by the usual off-white throw pillow in front of me, but my shoulders exposed and buzzing electrically. The torchiere in the corner was dim and blinding, and if I wasn't looking over at it, something was hiding, hunched in the shadow beneath it. But there was something hunched behind my chair, its hand wisping above my shoulder, and my head would jerk to glance at the hand, but then the corner shadow would shiver, and I'd jerk to look over there. If I concentrated, I could stare at a spot on the wall and see the corner and my shoulder out of my peripheral vision, but if my shrink distracted me with a question, one being or the other moved, and I was back to my mental game of keep-away.
My shrink said my name a couple of times, then, "Can you look at me for a minute?" I looked at his loafers and tried to ignore the other things in the room. "I think... that you might benefit from medication." The rest of the room disappeared, the other beings forgotten, and I couldn't breathe. "Violet, tell me what's going on." I realized I was standing, the pillow still in one arm, the other arm fending off phantom blows. I tried to stop moving, but my arm and hand and both shoulders spasmed uncoordinatedly. I was speaking.
"I'll be good, I'll be good, I'm sorry!" The words kept coming, a litany I was used to and hated, the way they made me feel like a small child, acting out. But I was acting out, doing it on purpose, the twitching, the glancing, I was just looking for attention, for sympathy, and I could stop on my own.
"It's not punishment, Violet." His voice had a musical tinge of laughter, not at me, but at the absurdity of my thinking. But it wasn't absurd. But it was. I was still chanting, "I'm sorry, I'm sorry."
"Just breathe. Stop talking and breathe." I took two deep breaths, but a wave of terror pulled me further away from land. Still, when the words came out now, they were different.
"But it the Prozac made me like this when I was on it, things in the corners and hands and things waiting to grab me, it was worse than now."
"No, no, I'm not thinking antidepressants, not for this." The wave receded and left me motionless, but I feared a bigger wave. He didn't continue, and it scared me. I could see his chin tilt as I stared at his shoes, and I knew he was considering his words. That scared me more, but somehow it was soothing; he was in the room with me. "This is going to sound scary, but I want you to hear all of it before you freak out. Any further." I took in a quick giggle breath. "You've heard of Risperdal."
Abnormal psych class; atypical anti-psychotics, schizophrenia, paranoia, delusions; low side effects. I nodded.
"Well, a number of psychiatrists — a small number still — have been using it to treat PTSD, the hypervigilance I think you've been feeling. It's a low dose, not what you'd use for schizophrenia. And it isn't sedating; it might make you a little drowsy the first couple of nights, but even that should be minor."
"It's not gonna... suck me down into, into nothing?"
"I don't think so." I was soothed again by the lack of absolute certainty. "If it does, you can stop."
"Okay."